心理干预结合活动性疼痛护理评估在肺癌患者术后疼痛管理中的应用效果

Application effect of psychological intervention combined with active pain nursing assessment in postoperative pain management of lung cancer patients

目的探讨心理干预结合活动性疼痛护理评估在肺癌患者术后疼痛管理中的应用价值。方法以2018年12月至2021年1月期间于南京医科大学附属脑科医院胸外科行肺癌手术的97例患者为研究对象,根据护理方法的不同将其分为对照组(49例)和观察组(48例)。对照组开展常规疼痛评估护理,观察组开展心理干预结合活动性疼痛护理评估。比较2组的日常功能恢复情况、术后疼痛情况及心理状态。结果观察组的术后首次下床时间和肛门排气时间均比对照组早(P均<0.05),术后第1天、第2天和第3天的下床步行距离均比对照组长(P均<0.05),术后功能受限程度较对照组轻,术后静息性和活动性疼痛强度均较对照组轻(P均<0.05)。出院时,2组的汉密尔顿焦虑量表和汉密尔顿抑郁量表评分均比术后24 h更低,且观察组的上述负性情绪评分均比对照组低,均存在统计学差异(P均<0.05)。观察组的疼痛最剧烈程度、疼痛最轻程度和有效咳嗽时疼痛程度得分均比对照组低(P均<0.05),中重度疼痛发生频率、疼痛信息告知充分程度和对疼痛处理结果满意程度得分均比对照组高(P均<0.05)。结论心理干预结合活动性疼痛护理评估应用于肺癌患者,能够改善其早期功能活动情况及心理状态,提升其术后疼痛管理质量,缓解其术后疼痛。

Objective To explore the application value of psychological intervention combined with active pain nursing assessment in the postoperative pain management of patients with lung cancer.Methods A total of 97 patients who underwent surgery for lung cancer in the Department of Thoracic Surgery at the Affiliated Brain Hospital of Nanjing Medical University from December 2018 to January 2021 were selected as the research subjects.They were assigned into a control group(49 cases)and an observation group(48 cases)according to different nursing methods.The control group was given routine pain assessment and nursing,while the observation group was given psychological intervention combined with active pain nursing assessment.The daily function recovery,postoperative pain,and psychological state of the two groups were compared.Results The first ambulation time and first anal exhaust time after surgery in the observation group were shorter than those in the control group(both P<0.05).The walking distance on the 1st,2nd,and 3rd day after surgery was longer than that in the control group(all P<0.05).The degree of postoperative functional limitation was lower than that in the control group,and the intensity of postoperative rest and active pain was lower than that in the control group(all P<0.05).At discharge,the scores of the Hamilton Anxiety Scale and Hamilton Depression Scale in both groups were lower than those at 24 hrs after surgery,and the above negative emotion scores in the observation group were lower than those in the control group(all P<0.05).The scores of the worst pain,the lightest pain,and the pain during effective coughing in the observation group were lower than those in the control group(all P<0.05),and the scores of the frequency of moderate to severe pain,the adequacy of pain notification,and the satisfaction with pain management were higher than those in the control group(all P<0.05).Conclusion Psychological intervention combined with active pain nursing assessment for lung cancer patients can improve their early functional activities,psychological state,and postoperative pain management quality,and relieve their postoperative pain.